Natural mortality and cause of death analysis of the captive chimpanzee (Pan troglodytes): A 35‐year review

We present the spontaneous causes of mortality for 137 chimpanzees (Pan troglodytes) over a 35‐year period. A record review of the pathology database was performed and a primary cause of mortality was determined for each chimpanzee. The most common causes of mortality were as follows: cardiomyopathy (40% of all mortalities), stillbirth/abortion, acute myocardial necrosis, chimpanzee‐induced trauma, amyloidosis, and pneumonia. Five morphologic diagnoses accounted for 61% of mortalities: cardiomyopathy, hemorrhage, acute myocardial necrosis, amyloidosis, and pneumonia. The most common etiologies were degenerative, undetermined, bacterial, traumatic, and neoplastic. The cardiovascular system was most frequently involved, followed by the gastrointestinal, respiratory, and multisystemic diseases. Degenerative diseases were the primary etiological cause of mortality of the adult captive chimpanzee population. Chimpanzee‐induced trauma was the major etiological cause of mortality among the perinatal and infant population. This information should be a useful resource for veterinarians and researchers working with chimpanzees.     

Honest signalling,dominance hierarchies and body condition in House Sparrows Passer domesticus (Aves: Passeriformes) during acute coccidiosis

Parasitic infections may change the equilibrium between the costs and benefits of an animal for maintaining its status in a social group. Consequently, parasites may influence the social status of an animal in a group. The present study investigated whether acute infection with Isospora spp. has any effect on the social relationships (e.g. dominance hierarchy) of male house sparrows and how the infection influences their behaviour, immune status, and body condition. Furthermore, the study allowed us to examine how important the ‘badge of dominance’ is with respect to maintaining social status even when the actual condition is changing as a result of infection. The results obtained showed that an acute infection leads to changes in the dominance hierarchy of a social group and that body mass losses of birds depend on the achieved hierarchy status. A positive correlation between the badge size and male aggressiveness was only found during acute infection. In addition, we also found a relationship between cell‐mediated immune response and male aggressiveness during acute infection. This suggests that male badge size is not sufficient to maintain a given dominance position. On the other hand, badge size, a signal developed during the moult, appears to remain an informative and ‘honest’ signal several months later, reflecting the energy reserves of a bird faced with a demanding stressful situation such as acute infection. © 2010 The Linnean Society of London, Biological Journal of the Linnean Society, 2010, 99 , 718–726.     

Cognitive behavioral therapy and fluoxetine for binge eating disorder: two-year follow-up

Objective: This study assessed the long‐term effects of group behavioral treatment plus individual cognitive behavioral therapy (CBT) and/or fluoxetine in binge eating disorder (BED) patients. Research Methods and Procedures: A total of 116 individuals were randomized to an initial five‐month trial and were followed up over two years. Assessments, including binge frequency, weight, and self‐report measures, were administered at pre‐treatment, post‐treatment, and ～6, 12, 18, and 24 months after initial treatment. Results: Across treatment groups, there was overall improvement over 29 months in binge frequency and in binge abstinence. The odds of binge abstinence 2 years post‐treatment were 1.373 times the odds of binge abstinence immediately post‐treatment. There was no significant change in weight over the two‐year period. Subjects who received individual CBT evidenced lower binge frequency over the two‐year follow‐up period than patients who had not received individual CBT. Similarly, CBT was associated with increased rates of binge abstinence. There were no main effects of treatment assignment on weight over the two‐year follow‐up period. There was a significant advantage for fluoxetine assignment over the two‐year follow‐up period on depressive symptoms. Discussion: The major significance of the study rests in its examination of the long‐term effects of standardized interventions for BED. Our findings provide support for the ideas that short‐term treatment may confer long‐term benefit and that not all treatments are equivalent in the benefits they confer.     

Prevalence of gingival overgrowth among elderly patients under amlodipine therapy at a large Indian teaching hospital

doi: 10.1111/j.1741‐2358.2011.00603.x
Prevalence of gingival overgrowth among elderly patients under amlodipine therapy at a large Indian teaching hospital Objectives: To determine the prevalence of amlodipine‐induced gingival overgrowth (GO) among elderly subjects attending an Indian teaching hospital and find any association with demographic factors, drug variables, oral hygiene status and gingival inflammation. Methods: A cross‐sectional pilot study included 157 dentate patients aged 60 years or more, taking Amlodipine for at least 3 months. Data were collected from past medical records and oral examination. Clinical assessment of GO was correlated with patient’s age, gender, drug dosage (2.5, 5 or 10 mg/day), duration of drug therapy (3–4, 4–6, 6–12, 12–24 and >24 months) and also with subjects’ plaque index and gingival index scores. Results: Eight patients (5.09%) had GO. No statistically significant relation was observed between age (p = 0.79), gender (p = 0.56), drug dosage (p = 0.25) and duration of drug intake (p = 0.62) and prevalence of GO. GO prevalence related highly significantly (p < 0.001) with plaque and gingival index scores. Conclusions: Prevalence of amlodipine‐associated GO in the sample of elderly Indian patients was noted higher than that previously reported. Plaque and gingival inflammation were highly correlated with this condition, while demographic characteristics and drug dosage did not relate significantly.     

Birth of a chimpanzee (Pan troglodytes) after artificial insemination with cryopreserved epididymal spermatozoa collected postmortem

A male chimpanzee (Pan troglodytes) suddenly died of acute hemorrhagic enteritis at the age of 18 years. Within 24 hours after its death, a large quantity of spermatozoa of excellent quality was recovered from the distal cauda epididymides and was subsequently cryopreserved. After storage for 67 days, the frozen spermatozoa were thawed and inseminated in an adult, normal cycling, nulliparous female. The optimal day for insemination was estimated by monitoring the swelling of the female’s sex skin and urinary luteinizing hormone concentrations. Pregnancy was confirmed by a urinary chorionic gonadotropin test, and a normal female infant was born after 214 days of gestation. This birth demonstrates that distal cauda epididymal spermatozoa recovered from a dead male can be cryopreserved and successfully inseminated in a female chimpanzee. Zoo Biol 20:135–143, 2001. © 2001 Wiley‐Liss, Inc.     

Critical effect of Helicobacter pylori infection on the effectiveness of omeprazole for prevention of gastric or duodenal ulcers among chronic NSAID users

Background. The recently reported OMNIUM and ASTRONAUT NSAID ulcer prevention trials using omeprazole to prevent endoscopic ulcer recurrence among chronic NSAID users suggested superiority over misoprostol or ranitidine. Aim. To test the hypothesis the results from the OMNIUM and ASTRONAUT studies would not be generalizible as ulcer healing and ulcer recurrence would differ in relation to Helicobacter pylori status. Methods. The data regarding H. pylori status were made available by AstraZenca allowing separate analysis of the outcome of those with NASID ulcers (i.e. without H. pylori infection) and those NSAID use was complicated with the presence of an active H. pylori infection. Results. Reanalysis confirmed that omeprazole was superior to placebo for the prevention of ulcer recurrence in chronic NSAID users. However, overall omeprazole was not significantly better than the subtherapeutic dose (400 µg/day) of misoprostol (14.5% vs. 19.6%, respectively, p = .93); 400 µg of misoprostol was actually superior to omeprazole for the prevention of gastric ulcers among those NSAID ulcers (8.2% vs. 16.6% for misoprostol and omeprazole, respectively; p < .05). Omeprazole was also not statistically different from misoprostol for gastric ulcer prevention in those whose NSAID use was complicated by an active H. pylori infection. Omeprazole was not significantly different from 300 mg of ranitidine for the prevention of NSAID gastric ulcers (14.6% vs. 11.6%, respectively, p = .56). Duodenal ulcers were over represented among H. pylori infected NSAID users and duodenal ulcer prevention was more sensitive to acid suppression than gastric ulcer. Conclusion. The OMNIUM and ASTRONAUT trials may have provided an unrealistic sense of security regarding the effectiveness of omeprazole for protection against ulcer recurrence in chronic NSAID users.     

Eradication of Helicobacter pylori does not reduce the incidence of gastroduodenal ulcers in patients on long-term NSAID treatment: double-blind, randomized, placebo-controlled trial

BACKGROUND: Helicobacter pylori and nonsteroidal antiinflammatory drugs (NSAIDs) are the major causes of gastroduodenal ulcers. Studies on the benefit of eradication of H. pylori in NSAID users yielded conflicting results. OBJECTIVE: To investigate whether H. pylori eradication in patients on long-term NSAIDs reduces the incidence of gastroduodenal ulcers. METHODS: Patients on long-term NSAID treatment and who are H. pylori positive on serologic testing, were randomly assigned to either H. pylori eradication (omeprazole, amoxicillin, and clarithromycin) or placebo. Primary endpoint was the presence of endoscopic gastric or duodenal ulcers 3 months after randomization. RESULTS: One hundred sixty-five (48%) of a total of 347 patients were on gastroprotective medication. At endoscopy, gastroduodenal ulcers were diagnosed in 6 (4%) and 8 (5%) patients in the eradication and placebo group, respectively (p = .65). During follow-up of 12 months, no symptomatic ulcers or ulcer complications developed. No significant differences were found in the development of gastroduodenal erosions, dyspepsia, or in quality of life. CONCLUSION: H. pylori eradication therapy in patients on long-term NSAID treatment had no beneficial effect on the occurrence of ulcers, erosions, or dyspepsia. Ulcer rates in both study arms are remarkably low, in both patients with and without gastroprotective therapy.     

Gorilla society: What we know and don't know

Science is fairly certain that the gorilla lineage separated from the remainder of the hominoid clade about eight million years ago, 2 , 4 and that the chimpanzee lineage and hominin clade did so about a million years after that. 1 , 2 However, just this year, 2007, it was discovered that although the human head louse separated from the congeneric chimpanzee body louse (Pediculus) around the same time as the chimpanzee and hominin lineages split, 3 the human pubic louse apparently split from its sister species, the congeneric gorilla louse, Pthirus, 4.5 million years after their host lineages split. 3 No tested explanations exist for the discrepancy. Much is known about hominin evolution, but much remains to be discovered. The same is true of primate socioecology in general and gorilla socioecology in particular.     

Multiple oral ulcers caused by incorrect use of oral bisphosphonate in a patient with dementia: A case report

It is not widely known that incorrect use of oral bisphosphonates (BPs), such as chewing the medication, can cause oral ulcers. An 83‐year‐old woman with dementia was referred to our clinic with multiple oral ulcers. Blood and histopathological examinations were inconclusive. Further questioning revealed that the patient chewed the oral BP, resulting in oral ulceration. Patients with loss of cognitive function, such as dementia, are at risk of oral ulcers caused by incorrect use of BPs.     

Ficus sp. and Musanga leo‐errerae: coexistent keystone fruits for chimpanzees in Kalinzu forest

The composition of Ficus sp. and Musanga leo‐errerae in Chimpanzees’ diet was investigated by faecal analysis and direct observation in the medium altitude forest of Kalinzu, along the albertine rift, south‐western Uganda. The fruit availability of Ficus species showed significant variations while that of Musanga leo‐errerae was consistent and significantly higher than that of Ficus (P = 0.053; t = ?2.034) all year round. Their consumption was not opportunistic as no correlation existed between their fruit abundance and their occurrence in chimpanzee faecal samples/diet (Musanga leo‐errerae: r = 0.153, P = 0.456; Ficus sp.: r = 0.039, P = 0.848). Results showed that Musanga leo‐errerae and Ficus species seeds occurred in 80.2% and 67.2% respectively of the total 2635 chimpanzee faecal samples analyzed. Although there was no significant difference between chimpanzees party size that fed on Musanga leo‐errerae and Ficus tree species, the rate of consumption was significantly different in the low (t = 3.835; P = 0.031) than the high fruiting season (t = 2.379; P = 0.063). Ficus sp. and Musanga leo‐errerae genera function as coexistent keystone fruits for chimpanzees because they perfectly complement each other in terms of chimpanzees’ sustenance. This information has significant implications in the management of tropical forests like Kibale, Budongo, Bwindi Impenetrable, Gombe and Mahale inhabited by primate populations especially the endangered ones like the chimpanzee.     

Nutritional status and oral status of the elderly with dementia: a 2-year study

doi: 10.1111/j.1741‐2358.2011.00555.x Nutritional status and oral status of the elderly with dementia: a 2‐year study Objectives: To determine the relationship between denture wearing and nutritional status in the elderly with dementia. Background: There could be a correlation between nutrition, oral health, dietary habits, patients’ satisfaction, and their socio‐economic status in the elderly, and the relationship between compromised oral status and nutritional status in the elderly with dementia. Subjects and methods: A 2‐year follow‐up study of 63 elderly Japanese women with and without dentures from a nursing home was undertaken to investigate their oral, physical and mental, and nutritional status. Results: Each item for 2006 and 2008 in this study showed no significant difference between 2006 and 2008, except the calories/day. The elderly with dementia without complete dentures during the 2 years of the study only significantly decreased the mean of the calories/day. Conclusion: The calories/day of the elderly with dementia without dentures decreased after 2 years. Denture wearing for the elderly with dementia could be necessary to maintain a satisfactory intake of calories.     

Oxygen consumption and haematology of juvenile shortnose sturgeon Acipenser brevirostrum during an acute 24 h saltwater challenge

This study focused on the acute physiological responses to saltwater exposure in juvenile shortnose sturgeon Acipenser brevirostrum. In two separate laboratory experiments, 2 year‐old A. brevirostrum were exposed to either full (32) or half‐strength (16) seawater for up to 24 h. First, oxygen consumption rates were used to estimate the metabolic costs over 24 h. Secondly, blood and muscle samples were analysed at 6, 12 and 24 h for water loss, various measures of osmoregulatory status (plasma osmolality and ions) and other standard haematological variables. Juveniles exposed to full‐strength seawater showed significant decreases in oxygen consumption rates during the 24 h exposure. Furthermore, seawater‐exposed fish had significantly increased plasma osmolality, ions (Na⁺ and Cl^?) and a 17% decrease in total wet mass over the 24 h exposure period. To a lesser extent, increases in osmolality, ions and mass loss were observed in fish exposed to half‐strength seawater but no changes to oxygen consumption. Cortisol was also significantly increased in fish exposed to full‐strength seawater. While plasma protein was elevated following 24 h in full‐strength seawater, haemoglobin, haematocrit and plasma glucose levels did not change with increased salinity. These results imply an inability of juvenile A. brevirostrum to regulate water and ions in full‐strength seawater within 24 h. Nonetheless, no mortality occurred in any exposure, suggesting that juvenile A. brevirostrum can tolerate short periods in saline environments.     

The effect of the boron-based gel on the treatment of diabetic foot ulcers: A prospective,randomized controlled trial

BackgroundChronic ulcers represent impaired healing capacity with high mortality in the elderly or patients with systemic disorders such as diabetes. Boron is an effective agent in wound healing by promoting cell migration and proliferation and reducing inflammation in the wound area. This study aimed to evaluate the therapeutic effect of a sodium pentaborate-based topical formulation compared to control on the treatment of diabetic foot ulcers.MethodsA prospective, double-blind, randomized controlled trial was conducted to apply randomly the topical sodium pentaborate 3% gel or topical conventional remedy (control) by patients diagnosed with diabetic foot ulcers. The 171 eligible participants aged 18–75 years received the allocated medicines twice a day for a month with an allocation ratio of 3:1. Twenty-five days and two months after the end of the trial, participants were reinvestigated for their ulcer condition and any recurrence. Wagner’s classification of diabetic foot ulcers was applied to this purpose (0−5).Results161 participants (57 females, 104 males; mean age: 59.37) completed this study. After the intervention, most participants in the intervention group had a lower ulcer grade than the control group (adjusted mean difference (95% CI): − 0.91 (−1.1 to −0.73); p < 0.001). Moreover, most participants in the intervention group (n = 109 (90.8%)) were treated at a higher rate than the control group (n = 5 (12.2%)) after intervention (adjusted odds ratio (95% CI): 0.008 (0.002–0.029); p < 0.001). There was no case of recurrence in the intervention group while its rate was (n = 2 (40%)) in the control group (p < 0.001).ConclusionThe present study suggests that topical sodium pentaborate gel may help treat and decrease the grade of diabetic foot ulcers and prevent the recurrence of diabetic foot ulcers.     

The older plant gets the sun: Age‐related changes in Miscanthus × giganteus phenology

Age‐related changes are usually overlooked in perennial grass research; when they are considered it is usually as a change in plant size (e.g., biomass). Whether other physiological or developmental aspects change as stands age, and how those aspects may impact long‐term stand dynamics, remains unclear. Conventional experimental designs study a single stand over multiple growing seasons and thereby confound age‐related changes with growing season conditions. Here we used a staggered‐start experimental design with three repeated planting years over two growing seasons to isolate growing season effects. We studied changes in Miscanthus × giganteus phenology during its yield‐building stage (first 3 years) and estimated age, growing season and nitrogen (N) effects on development using nonlinear regression parameters. Stand age clearly changed plant growth; faster developmental rates were usually seen in 1‐year‐old stands (young), but because 2‐ and 3‐year‐old stands (mature) emerged 3 months earlier than newly planted stands they produced 30% more stems with 30%–60% more leaves. Nitrogen fertilization modulated some age‐related phenological changes. Fertilized 2‐year‐old stands reached similar stem densities as unfertilized 3‐year‐old stands and had fewer number of senesced leaves like 1‐year‐old stands. In addition, N fertilization had no effect on young M. × giganteus, but extended mature stands’ growing season more than 2 weeks by hastening emergence and delaying senescence. It also delayed flowering regardless of stand age. Our results suggest that, along with changes in size, M. × giganteus stands showed shifts in developmental strategies: young stands emerged later and developed faster, while mature stands grew for longer but more slowly. In temperate regions, where hard frost events are likely to interrupt development in late autumn, rapid early development is critical to plant survival. Nonlinear regression parameter differences proved effective in identifying phenological shifts.     

Effects of 2 years of caloric restriction on oxidative status assessed by urinary F2‐isoprostanes: The CALERIE 2 randomized clinical trial

Calorie restriction (CR) without malnutrition slows aging in animal models. Oxidative stress reduction was proposed to mediate CR effects. CR effect on urinary F2‐isoprostanes, validated oxidative stress markers, was assessed in CALERIE, a two‐year randomized controlled trial. Healthy volunteers (n = 218) were randomized to prescribed 25% CR (n = 143) or ad libitum control (AL, n = 75) stratifying the randomization schedule by site, sex, and BMI. F2‐isoprostanes were quantified using LC‐MS/MS in morning, fasted urine specimens at baseline, at 12 and 24 months. The primary measure of oxidative status was creatinine‐adjusted 2,3‐dinor‐iPF(2α)‐III concentration, additional measured included iPF(2α)‐III, iPF2a‐VI, and 8,12‐iso‐iPF2a‐VI. Intention‐to‐treat analyses assessed change in 2,3‐dinor‐iPF(2α)‐III using mixed models assessing treatment, time, and treatment‐by‐time interaction effects, adjusted for blocking variables and baseline F2‐isoprostane value. Exploratory analyses examined changes in iPF(2α)‐III, iPF(2α)‐VI, and 8,12‐iso‐iPF(2α)‐VI. A factor analysis used aggregate information on F2‐isoprostane values. In CR group, 2,3‐dinor‐iPF(2α)‐III concentrations were reduced from baseline by 17% and 13% at 12 and 24 months, respectively; these changes were significantly different from AL group (p < .01). CR reduced iPF(2α)‐III concentrations by 20% and 27% at 12 and 24 months, respectively (p < .05). The effects were weaker on the VI‐species. CR caused statistically significant reduction in isoprostane factor at both time points, and mean (se) changes were ?0.36 (0.06) and ?0.31 (0.06). No significant changes in isoprostane factor were at either time point in AL group (p < .01 between‐group difference). We conclude that two‐year CR intervention in healthy, nonobese men and women reduced whole body oxidative stress as assessed by urinary concentrations of F2‐isoprostanes.     

Two-year internet-based randomized controlled trial for weight loss in African-American girls

Objective: A randomized controlled trial tested the efficacy of an internet‐based lifestyle behavior modification program for African‐American girls over a 2‐year period of intervention. Research Methods and Procedures: Fifty‐seven overweight (mean BMI percentile, 98.3) African‐American girls (mean age, 13.2 years) were randomly assigned to an interactive behavioral internet program or an internet health education program, the control condition. Overweight parents were also participants in the study. Forty adolescent‐parent dyads (70%) completed the 2‐year trial. Outcome data including BMI, body weight, body composition, and weight loss behaviors were collected at baseline and at 6‐month intervals. A computer server tracked use of the web sites. Results: An intention‐to‐treat statistical approach was used, with the last observation carried forward. In comparison with the control condition, adolescents in the behavioral program lost more mean body fat (BF) (?1.12 ± 0.47% vs. 0.43 ± 0.47% BF, p < 0.05), and parents in the behavioral program lost significantly more mean body weight (?2.43 ± 0.66 vs. ?0.35 ± 0.64 kg, p < 0.05) during the first 6 months. This weight loss was regained over the next 18 months. After 2 years, differences in fat for adolescents (?0.08 ± 0.71% vs. 0.84 ± 0.72% BF) and weight for parents (?1.1 ± 0.91 vs. ?0.60 ± 0.89 kg) did not differ between the behavioral and control programs. Discussion: An internet‐based weight management program for African‐American adolescent girls and their parents resulted in weight loss during the first 6 months but did not yield long‐term loss due to reduced use of the web site over time.     

Etanercept in the Treatment of Intestinal Behcet’s Disease

Behcet’s disease (BD) accompanied by intestinal involvement is called intestinal BD. Although recent studies have attained positive feedback with the administration of anti-TNF-α agents in patients with BD, only a few reports on the study of etanercept in intestinal BD have been found. In this study, 35 cases of intestinal BD were treated with conventional therapy (prednisone or methotrexate) for a minimum period of 3 months (group 1). Another 19 patients who failed to respond to conventional therapy were then treated with etanercept (25 mg twice a week for 3 months). During each subsequent relapse, the patients were given the same treatment. The main outcome measures were the four criteria for diagnosis of BD (buccal ulcers, genital ulcers, ocular lesions, and skin lesions), the manifestation of intestinal involvement (abdominal symptoms, double-balloon enteroscopy), laboratory examinations of the acute phase reactants (erythrocyte sedimentation rate) and C-reactive protein, and relapses. As a result of the administered therapy, the healing rate of buccal and genital ulcers, the remission rate of ocular lesions, skin lesions, and abdominal symptoms, the healing rate of intestinal ulcers, and the recovery rate of ESR and CRP were significantly higher in group 2 than those of group 1. The relapse rate in the etanercept therapy was reduced significantly when compared with conventional therapy group. In conclusion, etanercept treatment, in contrast to the conventional therapy, can result in better curative effect and less adverse reactions in intestinal BD.     

Synthesis and characterization of novel substituted thiophene derivatives and discovery of their carbonic anhydrase and acetylcholinesterase inhibition effects

Novel substituted thiophene derivatives ( 1, 2a‐e, 3, and 4 ) were synthesized and their structures were characterized by infrared radiation, nuclear magnetic resonance, and mass analysis. These novel substituted thiophene derivatives were effective inhibitor compounds of the carbonic anhydrase I and II isozymes (hCA I and II), and acetylcholinesterase (AChE) enzyme with K _i values in the range of 447.28 to 1004.65 nM for hCA I, 309.44 to 935.93 nM for hCA II, and 0.28 to 4.01 nM for AChE, respectively. Novel substituted thiophene derivatives can be good candidate drugs for the treatment of some diseases like neurological disorders, epilepsy, glaucoma, gastric and duodenal ulcers, mountain sickness, or osteoporosis as carbonic anhydrase isozymes inhibitors, and for the treatment of Alzheimer’s and Parkinson’s diseases as acetylcholinesterase inhibitors.     

Peptic ulcers and erosions are common in Israeli children undergoing upper endoscopy

Background: Peptic ulcers and erosions (PU&E) are thought to be uncommon in children. Patients with early exposure to Helicobacter pylori may be at a higher risk for early onset PU&E. Children in Israel have a high prevalence and early acquisition of Helicobacter pylori (H. pylori) and have easy access to pediatric gastroenterologists and endoscopy. Our aim was to describe the prevalence and characteristics of PU&E in this population referred by Pediatric Gastroenterologists for an upper endoscopy. Methods: We conducted a retrospective study over the years January 2003–May 2006. Over these years we had information on 751 diagnostic upper endoscopies. PU&E was regarded as erosive gastritis/duodenitis or ulcer in either the stomach or duodenum. H. pylori status was assessed using rapid urease test and gastric biopsies. Results: PU&E was detected in 169 (22.5%) patients (ulcers 51 (6.8%), erosions 118 (15.7%)). One hundred twenty‐four had gastric PU&E and 58 had duodenal PU&E. H. pylori was positive in 112 (66.3%). H. pylori‐associated PU&E becomes common after age 10 years, with gastric PU&E presenting much earlier than duodenal disease. Most of the H. pylori‐negative PU&E were idiopathic and improved symptomatically on PPI treatment. Interestingly, 43% of patients with PU&E in our cohort were either immigrants from the former Soviet Union or of Israeli Arab origin. Conclusions: PU&E appears to be common in this selected population with a relatively high incidence of gastric PU&E. H. pylori associated PU&E becomes common after age 10 years with gastric PU&E presenting much earlier than duodenal disease. Non H. pylori PU&E in children comprises approximately a third of all PU&E, are mostly idiopathic and appear earlier than H. pylori associated PU&E.